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首页> 外文期刊>The journal of maternal-fetal & neonatal medicine >The predictive value of the 1-h 50-g glucose screen for diagnosing gestational diabetes mellitus in a high-risk population.
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The predictive value of the 1-h 50-g glucose screen for diagnosing gestational diabetes mellitus in a high-risk population.

机译：1 h 50 g葡萄糖筛查对高危人群的妊娠糖尿病的诊断价值。

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Objective: To determine a value, for a gestational diabetes mellitus (GDM) screening test, above which the glucose tolerance test is obviated. Methods: A database search of patients delivered at the Medical College of Virginia Hospital (MCV) between April 1991 and April 2002 was undertaken. Subjects were screened using standard methodology: blood glucose level 1 h after a 50-g oral glucose load (1OGT). Subjects with values meeting/exceeding 140 mg/dl underwent 3-h 100-g oral glucose tolerance tests (3OGTT). GDM was diagnosed using criteria of the National Diabetes Data Group (NDDG), with Carpenter-Coustan (CC) criteria for comparison. Receiver-operator characteristic (ROC) curves were generated; areas under the curve (AUC) were calculated. Results: 1OGT results were available for 16 898 subjects; 2770 (16.4%) had values meeting/exceeding 140 mg/dl. The NDDG and CC criteria were applied to 1972 subjects with both 1OGT and 3OGTT results available: 419 (21%) and 614 (31%) subjects had GDM, respectively. Positive predictive values for results 180 mg/dl and values at 20 mg/dl increments up to 260 mg/dl were: 36, 47, 55, 57 and 63% (NDDG) and 45, 54, 62, 61 and 66% (CC). AUC for NDDG = 0.68; AUC for CC = 0.64. Conclusions: GDM cannot be diagnosed with the 1OGT; predictive values are low. A cut-off of 200 mg/dl predicts only 47-54% of GDM cases correctly, and may lead to over-diagnosis. It is inappropriate for GDM to be diagnosed based on the 1OGT.
机译：目的：为妊娠糖尿病（GDM）筛查测试确定一个值，在该值上方可避免进行葡萄糖耐量测试。方法：对1991年4月至2002年4月在弗吉尼亚医院医学院（MCV）分娩的患者进行数据库搜索。使用标准方法筛选受试者：口服50克葡萄糖（1OGT）后1小时的血糖水平。值达到/超过140 mg / dl的受试者接受了3小时100-g口服葡萄糖耐量测试（3OGTT）。使用国家糖尿病数据组（NDDG）的标准诊断GDM，并与Carpenter-Coustan（CC）标准进行比较。生成了接收者－运营者特征曲线（ROC）;计算曲线下的面积（AUC）。结果：16898名受试者可获得1OGT结果; 2770（16.4％）的值达到/超过140 mg / dl。 NDDG和CC标准适用于1972年有1OGT和3OGTT结果的受试者：分别有419（21％）和614（31％）受试者患有GDM。结果180 mg / dl和以20 mg / dl递增至260 mg / dl的结果的阳性预测值为36％，47％，55％，57％和63％（NDDG）和45％，54％，62％，61％和66％（ CC）。 NDDG的AUC = 0.68; CC的AUC = 0.64。结论：1OGT不能诊断出GDM。预测值低。临界值200 mg / dl只能正确预测47％至54％的GDM病例，并可能导致过度诊断。基于1OGT诊断GDM是不合适的。

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